Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v7i3.5553
Abstract
With the continuous expansion of medical equipment assets in large tertiary grade A hospitals, the contradiction between cost, efficiency, and technical depth in the traditional single maintenance mode has become increasingly prominent, necessitating a systematic governance framework to guide the optimal allocation of maintenance resources. Based on Donabedian’s “Structure-Process-Outcome” (SPO) three-dimensional quality evaluation model, this study explores the construction of a diversified collaborative maintenance framework for medical equipment applicable to large medical institutions, promoting the transformation of maintenance governance from “single-mode dependence” to “hierarchical and classified collaboration.” Through a systematic literature review and international comparative analysis, a multidimensional comparative framework for three mainstream maintenance modes was established; based on longitudinal data from a tertiary grade A hospital from 2023 to 2025, the SPO model was applied for structural diagnosis. The hospital’s three-year data showed that the total value of equipment assets increased by 21.3% (2.82 billion yuan→3.42 billion yuan), while the number of engineers increased by only 3 (14→17), with the ratio as low as 1:1123 (international benchmark: 1:250–300); annual maintenance expenditure increased by 8.8% (57.03 million yuan→62.04 million yuan), among which OEM maintenance accounted for continuously >60%, and the book COSR remained at 1.8%–2.0%, but indirect costs such as labor costs were not included. SPO diagnosis revealed progressive deficiencies in the current governance, characterized by “insufficient structural resources—incomplete process development—concentration of outcome modes.” This paper proposes a four-level hierarchical governance structure: Level A core assets adopt “OEM primary service + daily in-hospital inspection”; Level B critical equipment adopts “in-hospital preventive maintenance as the main approach + OEM technical support for major failures”; Level C general equipment adopts “in-hospital independent maintenance + audited third-party repair”; Level D low-value equipment adopts “replacement instead of repair.” This framework provides a theoretical basis and practical pathway for large medical institutions to overcome dependence on OEMs and build a sustainable maintenance ecosystem.
Keywords
medical equipment maintenance; SPO model; tertiary grade A hospital; diversified collaborative maintenance; OEM maintenance; cost-to-service ratio
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[13] Li Chaoqun, Zhao Chenggang, Wang Ying. A Bibliometric Analysis of Domestic Research on Medical Device Quality[J]. Chinese Journal of Medical Instrumentation, 2024, 37(18): 5-11.
[14] Siemens Healthineers. Healthcare technology management[EB/OL]. 2025. https://www.siemens-healthineers.com/en-us/services/healthcare-technology-management.
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[19] Fan Liping, Zhong Yinbao, Lang Lang, et al. Fault Tree Analysis of Multiparameter Patient Monitors Based on Aggregated Fuzzy Numbers[J]. Chinese Journal of Medical Physics, 2021, 38(6): 725-731.
[20] Mi Rong, Chen Zhongjian, Hu Peng. Analysis of the Value of Whole-Process Collaborative Management of Medical Equipment in Equipment Quality Assessment and Quality Control[J]. China Medical Equipment, 2023, 20(9): 123-128.
[21] Yin Ke, Yang Fang, Dai Shanshan, et al. Research on the Application of the Refined Management Concept to Quantitative Management of Hospital Medical Equipment Maintenance[J]. China Medical Equipment, 2021, 18(11): 159-162.
[22] Feng Chunyan, Han Kuanhuai, Li Xianhua, et al. Practice of Refined Management of Hospital Equipment[J]. Chinese Medical Devices, 2021, 36(5): 140-143.
[23] Zhang Guixin, Wang Wei, Wang Xueyao, Chen Huimin, Yang Jianying. Research on the Construction and Application Value of a Hospital Ophthalmic Equipment Maintenance Model Based on the Delphi Method[J]. China Medical Equipment, 2025(5): 137-141.
[24] Yang Ying, Wu Heyu, Ma Qiong, Zhao Shiyu, Li Sha, Yao Chong. Construction of a Quality-Sensitive Indicator System for Medical Equipment Management in Operating Rooms Based on a Three-Dimensional Quality Model[J]. China Medical Devices, 2023(3): 101-106.
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